Provider Demographics
NPI:1639158116
Name:FRIEDMAN, PETER C (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:C
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E ECKERSON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-7153
Mailing Address - Country:US
Mailing Address - Phone:845-352-0500
Mailing Address - Fax:
Practice Address - Street 1:200 E ECKERSON RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-7153
Practice Address - Country:US
Practice Address - Phone:845-352-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233949174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI33169Medicare UPIN
NY3K5001Medicare PIN